The Complete Guide to Choosing a Head Rest for Your Massage Table by Leif Montgomery

Bodyworkers are presented with a wide array of choices of head rest support for their massage tables. We break it down for you so you can make an informed choice when you are ready to purchase.

Adjustable Platform

Boiance Pillow Pad by Oakworks

Let’s define what we mean by “head rest”. The Head Rest is an attachment that supports and positions the head and face. It inserts into one or both ends of the table and is comprised of a platform that both inserts into the table and acts as the foundation for the pillow pad (or cushion) which attaches, usually with Velcro to the platform.

There are standard specifications for the fit of the head rest into the table, but not all manufacturers follow it. Standard dimensions are as follows – outside to outside 8”7/8, with 7/8” diameter holes. In theory, if your table has these dimensions, you may mix and match from the array of available head rests (with matching pillow pad) as well as different pillow pads with different bases. If your table does not have standard specifications, then you must use only the manufactures head rest design, or have aftermarket holes drilled to spec for the table. Here is a list of some of the more well-known companies and their specifications. (If your favorite company is not listed, simply ask them if they conform to the standard measurements, or if other manufactures head rests will fit)

We mentioned that the head rest consists of the platform and the pillow pad. So this means, in theory, that not only can you mix and match head rests, but you can mix and match pillow pads. We will talk more about that later.

The Head Rest Candidates:

The plain vanilla Standard Head Rest

The first Head Rest I am presenting is as extinct as a pterodactyl: the much maligned rarely seen “plain” (straight, standard, non-adjustable) head rest. I aim to bring this head rest back to life. Buy it here.

Here’s why: Sometime, somewhere, when you least expect it, your fancy head rest will break. Perhaps your head rest is top notch with a lifetime guarantee, or a cheapo model purchased in a back alley. Regardless, all adjustable head rests have moving parts prone to breaking either through regular use, or when someone decides to use the head rest as a support when turning over or decides it’s a nice seat. When this happens, you will wish you had a backup because you will be out of business until you replace the head rest. The plain “pterodactyl” head rest is the perfect for this. Trust me on this!

Basic Adjustable Head Rest

The most common head rest on the market is the standard single lever adjustable head rest. The single lever adjusts both the tilt (angle) and the height of the head rest. This simple design creates one of the most functional head rests. The platform allows an excellent surface foundation to affix the pillow pad (which is usually sold together as a unit). You can easily mix and match different pillow pads with this unit. Many different manufacturers use this head rest design, but quality varies widely. Stick to the major brands mentioned above. This remains my favorite head rest.

Quick Lock Adjustable Head Rest

This type of head rest is manufactured by Oakworks. The double levers allow a huge range of adjustment in height and tilt, some variations totally out of the realm of what you would practically use. Two things to keep in mind with this design: because of the double pivot design, the pillow pad will sit quite a ways from the end of the table leaving a gap. Also, notice the tubular construction – this has much less surface area to affix the pillow pad – thus you will be limited to using the specific Oakworks pad, which has a platform surface built into the actual pillow. If you try using other pillow pads without reinforced backing, the pad may collapse offering little support for the face. Personally, I am not a fan of this design for tables, however, I do like this on massage chairs, for instance the Portal Pro, where it works great.

EarthLite Flex Head Rest

The Flex Rest elaborates on the common adjustable head rest adding flex into the platform. The idea is that movement and flex aids in comfort for the recipient. The Flex Rest uses a memory foam pillow pad that is designed to be used with the flex rest platform. Thoughts on this system. The design allows more adjustment than the standard single lever: it will go lower and higher. However, this comes at a price, in my opinion anyway. The head rest will not sit flush up against the table the way the simple adjustable head rest will. It does not leave as much of a gap as the Oakworks, but still that gap may be issue for some of you. The foam also is quite soft and with deeper work or if the recipient tends toward forward head posture, the recipients face could compress all the way to the platform. If you check other reviews floating around on this, you will see these points repeated.

Earthlite Caress Head Rest

The Caress Head Rest is similar to the Flex Rest with the main difference being that it uses a sequence of petals to produce the flex in the platform. The Caress and Flex Head Rests use the same type of memory foam pillow pad. The pedals are more prone to getting damaged, so my advice would be: if you like this style of head rest, chose the flex if you transport your table, move it around a lot, or have many different therapists working on it. Otherwise, if your table remains mostly stationary and the head rest is treated with care, the Caress will work for you. Take into account the same considerations mentioned above regarding the flex rest while considering if this design will work for your needs.

Stronglite Curve Head Rest

This head rest uses a radically curved platform on which a pillow pad is affixed. Aside from that, it shares the single lever design for height and tilt adjustment. My take is it looked more comfortable than it actually was. The pillow pad is surprisingly hard. Your mileage may vary.

That’s it for the most common Head Rest designs.

Now, let’s take a look at the various Pillow Pad options.

As I mentioned before, most manufacturers make the head rest platform and head rest pillow pad as a unit and sell together. But this does not stop you from being able to mix and match platforms and pillow pads if you choose. Just keep in mind that many are sold as a unit for a reason – Like the Oakworks platform (double lever Quick Lock) requires the pillow pad has the support built in, limiting your choices. Otherwise, go ahead and experiment.

Pillow Pad Candidates

Memory Foam Pillow Pad

This pillow pad is made completely from memory foam (which contours to the shape of the face when warmed with body temp). It is covered in cloth fabric (rather than traditional, much easier to clean, Vinyl) making it essential to protect and cover this pillow pad. You can machine wash, but it’s not the easiest thing to remove and re-cover over the foam. Note that you can buy replacement covers at a reasonable price, if needed. This pad is big and soft. Avoid if easily claustrophobic! Because it is pure memory foam, there is the possibility of it compressing all the way down to hitting the platform with enough pressure and heat. Some like it and some don’t. The one shown in the picture is made by Earthlite.

Oakworks Boiance Pillow Pad

This creation from Oakworks incorporates multi-layer foam cushioning with water spheres. The aim of this design and construction, according the literature from Oakworks, is to create a comfortable relaxing pillow pad that conforms better and reduces pressure. In my trials of this pillow pad, I find it large and soft, like other aftermarket pillow pads. Initially it feels super plush but as soon as any pressure was applied to my back, my chin started sinking eventually resting on the head rest platform. This is the flaw of most pillow pads that mistake soft and plush for functional. You can try to limit the lack of support by adjusting the pillow pad and changing the height and angle of the platform, but I was never able to get it quite right.

Oakworks Boiance Float

The Boiance Float is a companion to the Boiance. It is not strictly a pillow pad, but an insert that rests between the platform and the pillow pad. It can us used on most head rests, with the exception being the flex and caress as these probably do not offer enough stability to affix it. The Boiance Float allows the pillow pad to float, or move around, during the treatment. It’s like being on a cruise ship. Is that a good thing!? You be the judge. Oakworks’ literature states that the Float eliminates cervical compression. The only thing I noticed is that all the inherent weaknesses of head rests remained while the float was on, but my head was moving around – like a bobble head.

Nirvana Ergo Fix

At press time, this was in proto-type phase, but I was actually able to see and try the product and was pleasantly surprised. I have seen, tried and bought so many headrests over the years and this one approaches positioning from a new perspective. This design adds support to the chin to distribute the weight over the entire face which has the effect of decreasing pressure on the sinuses and relaxing the curve in the cervical spine. Oh, yeah and no more clients complaining that their chins are falling through or fidgeting around to try to get comfortable.

Conclusion – So, what to make of all this? Which head rest should you use? Like many things, the answer is not straightforward. Choosing a head rest is a bit like choosing a pair of shoes. Personal preference and tastes will come into play, and what works for one person might now for another. However, within the variations one might choose, all shoes must protect and provide some sort of support for the feet. Head Rests are like shoes, some look great and don’t function well and others you might like so much you buy a pair in every color. Choosing the right Head Rest should involve a balance between function and comfort. I’ve concluded that sometimes simpler is better. In doing your own research you should trust your observational skills and brush up on your postural analysis and your anatomical knowledge. Hope this has been helpful.

Practitioners and consumers have a wide array of products to choose from for topical pain relief, cooling/warming products, that can be used to massage onto the skin to treat specific areas or more regional massage treatments. Picking the appropriate one can be a little confusing. We are going to break it down for you to make your work a cinch.

Professionals and consumers seek these products for pain relief, attributed to muscle soreness from over exertion, sports or arthritis.

Active Ingredients – Simplifying the search. There are literally thousands of products that fall under this category. But almost invariably, they all share just 3 active ingredients: Menthol, Camphor, and Capsaicin. And to make it even simpler, Capsaicin is rarely used in massage applications because of difficulty in handling, leaving Menthol and Camphor, in that order, as the common ingredients.

Let’s take a closer look at each one:

Menthol:
Menthol in its natural state is derived from peppermint or other mint oils. It is a waxy, crystalline substance, clear or white in color, which is solid at room temperature.

How it works: Menthol creates the well known cooling sensation not by actually lowering temperature, but by chemically activating the cold-sensitive TRPM8 receptors in the skin. Menthol’s pain reducing properties are mediated through a selective activation of κ-opioid receptors.

Camphor:
Camphor is found in wood of the camphor laurel (Cinnamomum camphoraa), a large evergreen tree found in Asia. Today it is mostly derived from the oil of turpentine.

How it works – Camphor is readily absorbed into the skin and acts similarly to menthol with the addition of acting as a slight local anesthetic and antimicrobial substance.

Capsaicin:
Capsaicin is the active component of chili peppers.

How it works – Capsaicin works by depleting or interfering with substance P , a chemical involved in transmitting pain impulses to the brain.

Making your decision:Choose your Strength Percentage – Now that you have an understanding of the active ingredients and their properties, it’s time to decide how strong or concentrated you want your application. Higher percentages, 6-12%, tend to be used for spot treatments, or a take home application for consumers. The more dilute formulas, approx 3%, are suited to more broad area applications where you will be incorporating the product in your massage or deep muscle treatment.

The Hard Part (lots of choices) – Now comes the part where you have to choose how you want the active ingredients delivered. There is a wide range of variation here. You’ll find balms, gels, lotions, sprays, patches. There are very clean formulas, somewhat clean, and downright chemically formulas I wouldn’t touch in a hazardous materials suit.

We have a list of some of the more popular items below with ingredients. Outside of that, armed with the knowledge learned here, you can do independent research to see which items suit your needs.

Here is a closer look at some products:

Biofreeze – probably the most popular entry in the category. You may be surprised to learn the menthol content is only 4% (10% in the sprays) because it feels quite strong. Note that alcohol is present in the formula creating an evaporation effect adding to the cooling sensation. Biofreeze is offered in everything from a roll on to single use. It’s trademark green color is derived from artificial coloring, but smartly, a colorless formula is available.

Tiger Balm – another well known brand. Tiger Balm has 10+ percentages of menthol and camphor making it a spot treatment only application. Tiger Balm uses paraffin petrolatum and mineral oil in its formulas. Not my cup of tea – I’d prefer to avoid that on my skin!

Sacred Earth Warming Lotion – really nice consistent product. Big customer favorite. 3% menthol means is great to incorporate into a full treatment. But why “warming” you ask? I ask the same question and directed it to Kyle of Sacred Earth. (You can call also and probably get to speak to him directly. Sacred Earth and Kyle get a 5***** rating in terms of information and ethics). I learned it’s the addition of cinnamon that creates the warming effect. Fantastic. I urge you to try this product.

Popular formula from the biggest name in massage lubricants – note: it appears this formula still uses parabens – but to be fair, if you are not using parabens, you are using some other preservative….and no matter what anyone tells you, there is no “natural” effective one.

In this section we look at relative weights of massage tables from standard to lightweight to super lightweight. We are not looking at the specific construction of each table but rather at the weight categories (although we will add that every table mentioned in our review is one that we have used and sold). For more on choosing a table read Leif Montgomery’s Guide to Choosing a Massage Table in the Buyers Guide Section of this blog.

While the specific weight of each massage table is useful information, we have found a discussion of relative weight to be more relevant for those choosing a portable massage table for transportation. How does the table “feel” to you compared to your current table? While 30 pounds may sound manageable – think about carrying your table up stairs, lifting it in an out of your car or carrying it for 2 blocks / 5 days a week!

Categories and Weights

Standard Portable – 30lbs (add kilograms too for metric) and up. This is the most common category of portable tables used and sold today. The table shown in our video is the Oakworks Nova, Other tables in this group include the Earthlite Spirit, Nirvana 2N1, Stronglite Premier, etc.

Lightweight – 25-30lbs. Here we look at the Stronglite Versalite. Others tables in this category are the Earthlite Luna and Oakworks Wellspring. You may have noticed that our measured actual weight varied by quite a bit from the manufacturer’s stated weight. Things like variations in fabric and foam can contribute to small variances in weight but over 1 pound is a big variance when you are talking under 30 pounds.

Super lightweight – 25lbs and under. Here we looked at the Dharma Super Light. The other table we like in this category is the Pisces New Wave.

Note – table weights generally refer to the table only and do not include the weight of the carry case or head rest. During actual use, you will tote a few accessories like a head rest and bolster which will add a few pounds. A carry case with well designed handles and shoulder strap will distribute the weight over your body making it easier to carry.

Bulk – Besides weight, the bulk or size of a table also factors into the ease of transporting it. Always go as narrow as you can without sacrificing comfort.

So now, we come back to the true test in choosing a table that will be transported and used for out calls. Lift it in the real world under working conditions! We have found over the years that most therapists, especially new practitioners, find that standard weight tables “feel” OK when you lift them the first few times. Many therapists re-evaluate after carrying their tables around for a few years. This is when practitioners may decide to explore purchasing a lighter table or they may even encourage their clients to buy their own table. Lightweight Massage Tables can save the practitioner up to seven pounds! This may be too heavy for some people with back or strength problems. If you fall in this category then you should consider investing in a super light massage table. These tables feel remarkably and refreshingly light, as you can see on the video, “woo hoo”! When you get under 25lbs, even 1-2 lbs variations can make a big difference, so choosing foam and fabric variations to save weight makes sense.

Good luck in you table search! For more fun and information watch our video on the Science of Choosing Lightweight Tables

Strength Ratings/How to evaluate the strength of Portable Massage Tables

A portable massage table is actually an engineering marvel. It’s generally lightweight, portable, folds in half, and has to support up to 20 times its own weight. In choosing a portable massage table of course strength will be one of your considerations. And if you are like most people, you will look for the manufacturer’s strength rating and choose the one with the highest number. Unfortunately, like a lot of things in life, it’s not this simple. The strength ratings offered by manufactures are ambiguous, the terms are not clearly defined and it’s impossible to compare apples to apples. Some companies will not even tell you how they test their tables! You see, there is no one standard, no objective 3rd party auditing claims or agreeing on definitions or standards. You have to take all these ratings with a huge grain of sea salt from the Dead Sea. These ratings are meant to obfuscate; to confuse and muddy the waters. I dislike obfuscation. Fortunately for you, Leif is here to lead you down the righteous and enlightened path to owning a massage table. So now that you agree the ratings are mostly meaningless, or to be made fun of (see below) how do you grade strength?

I am going to show you two ways to achieve this by putting more knowledge and information into your hands and empowering you to confidently make decisions.

One way, though not scientific (but certainly as scientific as “strength ratings”) is to see how a particular table has performed over time. It’s a valid way to measure things and you probably do it with other categories of products already. Find an objective source that handles or sells lots of tables. This can be a dealer or school that handles or sells a variety of tables and can offer objective views on them.

The other way is to learn a little bit about table design. Here are the keys to good table design.

2) Quality Control – Inspect the raw materials for integrity and also the components at each stage of manufacturing

3) Integrated Design – the parts, hardware and components all need to work in harmony once the table is put to work and is load bearing.

Please do not take offense at this next section! I am not commenting on whether these tables are good or bad I am merely showing the crazy world of strength rating.

A Look at the wonderful world of Strength Ratings

Manufacturer

Model

Static Weight Rating

Working Weight: also known as Max working weight, Operating weight, etc

Earthlite

Spirit

3200 lbs

800 lbs

Oakworks

Nova

Doesn’t say

550 lbs

Pisces

New Wave

2000 lbs

500 lbs

Astralite

Pro

2026 lbs

450 lbs or 250 on ends

Master

Champion

1500 lbs

Doesn’t say

Stronglite

Classic

4000 lbs

Doesn’t say

Best Massage

Eco Body Choice

1800 lbs

700 lbs

We have the Eco Body Choice @ $139 with 700 working weight vs the Oakworks Nova @$400 at 550 working weight. The Oakworks Nova, with a long history and probably the most internal testing loses to a table from Best Massage. Hard to believe, unless you add in a dose of BS and hype.

Look at the difference in static weight between Stronglite (4000 lbs) and Earthlite (3200 lbs). It’s no secret that Earthlite and Stronglite are owned by the same parent company. Don’t they share their trade secrets?

Why did Astralite stop at 2026? Why not 2026.53? Is every table tested by the pound? Did just one table test to this weight and we now assume all test this this precise measurement?

Pisces sports a very average 2000 and 500lbs. Years ago, these would be great numbers. Here is some advise for Pisces: Your table lies on the floor : Claim that it can support a Mach Truck! Then you will fit right in with the crowd!

And the winner goes to…

Master Apollo Chair (not a table, but I had to add it in!) claims 1000lbs working weight and static weight. It’s unclear which as their literature states both. Imagine a cow running and jumping onto the chair. This would be the equivalent of 1000lbs of working weight. I am going to make a wager here – Me and my cow break this chair before they change their strength rating.

In conclusion, if you still insist on using strength ratings, I have created, with the help of some math PhD’s, the following equation:

Budget – Cost is the first consideration in purchasing a massage table. Decide on your budget. Lower cost does not necessarily equal lower quality. I never recommend sacrificing quality in choosing a table. Follow my recommendations to get the best table with the correct options, for your needs. I am placing the cut off point at a minimum of $200 (with shipping) for a complete table (table, head rest and carry case). You can go cheaper but the return on investment becomes less compelling when you decide that $89 sounds like a great price for a table! There is no point in purchasing something that is not suited to your needs or compromises your client or receivers comfort or relaxation all for the sake of saving $25.

Table Type – To make your decision easier, I find it useful to group massage tables in categories; Entry Level, Professional, and Lightweight.

Entry Level Massage Table: If your budget is limited, this is where your search will begin. Perhaps you are a student or potential student, want a table for home use, or are not ready for a higher end table. Your goal and focus will be on maintaining quality, buying a table with a sound foundation and solid reputation. You will need to skip some of the more expensive options (which you may be able to purchase later after market), and zero in on the specifications that suit your body and treatment style.

Gimmicks to avoid: (1) in an effort to reduce costs some manufactures will resort to “seconds” quality in the raw material to build the table. In most cases a “cosmetic” flaw would not bother me as long as it doesn’t affect the stability or construction. An example of a cosmetic flaw might be a discoloration or small tear in the fabric. If however there is a knot in the wood in the wrong place it can dramatically weaken the table making it prone to splits and cracks which are the most dangerous type of table malfunction. (2)”Thick” foam in cheap tables; quality foam is expensive and if the table is cheap and the foam thicker than you would expect you should be skeptical. Nothing feels worse or wears out faster than cheap foam. You can always add a layer or quality fleece pad to your table later for additional padding. (3) Quality control/Reputation: the construction of the table and the reputation of the company, especially if you care about after service, should factor into your considerations. Do your own research, discuss with your school or talk to an objective distributor to gather information. A little thing like a broken head rest or an end plate not fastened correctly could create a lot of grief and time lost for you.

Professional Massage Table: Purchasing a professional table generally gives you more freedom to customize your table and the certainty that you are getting the best quality construction and raw materials like wood, foam and fabric. Professional Massage Tables often have layered foam, high quality fabric and the option to choose from various widths to suit your height and style. Higher quality materials can add weight to your table so expect a professional table to weigh in between 30 and 35 pounds. Professional massage tables offer more comfort and support and often have standard features like reinforced open (Reiki) endplates or rounded corners.

Lightweight Massage Tables: If you plan on transporting your massage table or if outcalls make up a large portion of your business you will want to consider a lightweight table. The savings in wear and tear to your body can be significant. If built correctly, lightweight tables will provide all the strength and quality of a regular massage table at a much lighter weight. This weight savings is accomplished by using lightweight aluminum alloy in place of wood on the under structure and creatively using foam layers to retain comfort yet keep the table light. I don’t recommend adding additional foam to your table because foam adds weight and cost which defeats the purpose of buying a lighter table. Additionally, some manufacturers are using innovative materials (aluminum and ballistic fabric) in place of traditional (wooden) table top frames which are usually made of poplar and plywood. A true lightweight table should be 25 pounds or less. Some manufactures offer lightweight tables that are over 25 pounds so I am going to break lightweights down into 2 categories; super lightweight and lightweight.

Width: The average table width for a wooden table is 30 inches wide (76cm) and, slightly less for lightweights which is more like 29 inches (74cm). The factors to consider for table width are as follows:

(1) Bulk – if you are transporting your table any extra width is bulk you need to lug around. Lightweight massage tables tend to be on the more narrow side in order to avoid the bulk factor.

(2) Client Comfort – New students tend to favor client comfort and therefore may choose a table that is too wide or too heavy for them. Choose wisely – remember a practitioner in pain is not going to give a good treatment! Therefore choosing your table width should be a balance between your comfort and your client’s comfort. The goal is to maintain proper body mechanics while keeping your clients happy. If you practice a modality that requires your client including their arms to fit on the table in supine position then you will need a 32 inch+ wide table. The reason a wider table can be problematic is that the practitioner will need to reach further across the table to work. This has the potential to create back pain in shorter therapists or those with existing muscular / skeletal conditions. Some practitioners like physical therapists prefer a narrower table so they can get in really close and practice range of motion techniques (see later in article).

Length: The table length is usually fixed at 72-73 inches (185cm). This length seems to accommodate all body types and styles. When lying prone (face down), the removable head rest option adds another 12 inches (30cm) of length. When lying in supine position a bolster can be used under the knees to effectively shorten the height of your client. It is customary to remove the head rest in supine position however, if you have a very tall client you can use the head rest as a pillow pad for the clients head and let the feet fall over the end. Most tables also have the option to add a footrest which typically gives you another 9 inches in of length.

Table Height: Ideal table height is determined by several factors: personal preference and ergonomics, modality or style performed, and advice and direction from your massage school (hopefully they taught this!). Almost all tables come standard with adjustable height approximately 24 inches (60cm) to 34 inches (86 cm). This height range accommodates most practitioner heights and preference combinations. If you fall outside of this range, you will need a custom built height range. Several manufactures offer this. Call around if you require this. The height adjustment is achieved through a simple process of knobs (single or double) and adjusting the leg height, or push button in the case of aluminum lightweights. Generally, there are approximately 8 height choices within the lowest and highest range.

Foam: More foam does not equal better foam! Foam quality is related to the density of the foam not the thickness. The trick with massage tables is to create a comfortable and supportive surface without tipping the scales. Watch out for cheap tables with 3″ or even 6″ of foam. You might end up with a “brick” of foam which is either mostly air or hard as a rock. Better foams will have a firm supportive base yet feel plush. Often times the more creative manufactures will layer foam to create a better working surface. Remember, in massage not only are you lying on the table, but you are being pressed, kneaded and rolled. You do not want mush for foam!

Table Surface: This is a first! You will not see any other massage table reviews discussing table surface as a choice. I am happy to be breaking new ground here. Lying down on a massage table can be uncomfortable especially in prone position. Why? Because the table is flat but the body is not! A head rest is nice, and a bolster under the ankles as well but how about the rest of the body? Ideally we want the skeletal structure to support the pressure and not the soft tissue. When you think about this it makes total sense. Not only is the recipient more comfortable, but the treatment and relaxation process more effective with better support. Therefore, I ask you to consider this along with everything else as you make your table choice. Probably in the future, this will be standard equipment.

Already have a table, but are convinced table surface ergonomics makes sense? Read on below for table accessories we will consider.

Fabric: Fabric should be both durable and easy to clean. Fabric technology has come a long way in the last few years. While still synthetic material, the new materials are much nicer, softer and more environmentally friendly. Older and cheaper massage tables use fabrics with PVC (vinyl plastic) which is more damaging to the environment and releases harmful chemicals through a process called out gassing. The most reputable manufacturers use higher quality fabrics which are polyurethane based PVC free. Some manufacturers offer a higher quality vinyl called ultra leather. Ultra leather is typically PVC free, softer, lighter weight and more expensive. While I love this fabric the standard that comes on most quality massage tables is very sufficient. I do recommend the upgrade for lightweight tables if you can afford it because it will save 1 to 2 lbs of weight. At 34lbs for a regular table the weight savings will hardly be noticeable, but at 25lbs the weight savings does make a difference.

Table Options

Face Rests: Face Rests provide more comfort for face down massage by supporting the face with a pillow pad and alleviating stress on the neck. Most are removable and use extensions which insert at either end of the table. Face rests or face holes that are built into the table are also available but less common. Keep in mind these will effectively shorten the table in prone position and require specially cut fitted sheets. There are many different styles and types of face rests. The most common are “Straight” head rests which are non-adjustable but very stable. Adjustable Head Rests typically adjust in tilt and height. Moving parts can create the potential (although rare) for damage. There is a range of headrests and new technology in foam and adjustments which I will review in more detail in another segment.

Bolsters: Bolsters come in a variety of shapes and sizes from fully round to flat on one side to semi round. They are traditionally used to support under the ankles in prone position, and the knees and neck in supine position.

Arm Shelf/Table Extension/Side Arm Extenders: Sometimes it is useful to add some length or width to your table. The table extension is inserted into the head rest outlet holes and adds approx. 12″ of length to your table. The universal side arm extenders (bolster armrests) add approx 4 inches (10 cm) on either side (total 8 inches, 20 cm) of your table. Bolster Armrests can be adjusted to fit most tables. They are attached by straps which drape across the table surface and then are further secured with Velcro on the inside table top frame and a snap closure under the table top. Although they will not support total body weight they are surprisingly secure. Arm Shelves are a nice option to support the arms under the face rest. Arm shelves come in a variety of styles, from the simplest arm sling to shelves screwed directly into the table leg or secured from the above table top rail. Most can be used on a variety of tables but some are manufacturer specific.

Carry Cases: Carry cases like head rests are usually included in the purchase of the table. They can also be purchased separately. The case is designed to protect your table and fabric. The bottom of the case is reinforced with tougher material to protect against abrasion. There are several handles and a shoulder strap to make transporting easier. You will find single pocket and multi pocket designs to help carry your accessories. Some cases have wheels attached. I prefer a table cart, which you may take on and off as needed. The case with wheels adds bulk which will require you to list the table higher as you go up steps or stairs.

Linens: Keep your table fabric looking new with these tips. Never allow oil to remain on your table fabric. Over time oil will dry out and crack the fabric. Clean oil stains immediately with a soap and water or suitable mild cleaner. Linens can help protect your table from oils and tears by creating a barrier between sharp objects and the surface of your table. I usually leave tears alone. Some people choose to use a vinyl repair kit. You can find these in any hardware store. Most practitioners use cotton flannel linens. These are custom made to fit massage tables. A sheet set includes a fitted sheet, a flat sheet and a crescent cover for the face rest. Also common are cotton/poly and interlock jersey sheets. If you do outdoor or sports massage, I find fitted plastic sheets very useful and protective.

Positioners: As promised above, no discussion of massage tables would be complete without a discussion of positioning. The hest rest and bolster will address the immediate need for properly supporting the head, neck and lower legs. For the torso, in prone position, here are the 3 items I find most effective:

Nirvana Body Wedges: These simple triangular wedges are designed to fit right under the hips, specifically supporting the ASIS (anterior superior iliac spine). The further they are inserted, the higher the hips are supported. This can reduce pressure on the low back.

Body Cushion: This is almost like a massage table on a massage table. Through a series a contoured foam layers, a hip support, a torso support and a head rest, a platform is designed to support the body’s skeletal structure while keeping pressure off areas of soft tissue like the breasts and stomach.

Nirvana Mate: This achieves the same goal as the body cushion in a simpler system at a fraction of the cost. The Nirvana Mate uses contouring and soft tissue recesses to achieve a more comfortable and effective treatment. The Mate is a perfect after market product for those wanting the ergonomics offered in the Nirvana Massage Table but already have a flat table.

Whew! I’m exhausted. I think I gave you a good bit of information to digest for now and hopefully enough for you to make and informed purchase. Good luck!

One of the most common questions I get asked is: “How do I choose a massage lubricant”?

Massage Lubricants are used to reduce friction, allowing optimal interaction between the practitioner and receiver.

The main characteristics of Massage Lubricants are glide and viscosity:

Glide: Glide refers to the amount of friction or control.

On one side the spectrum you have acupressure, or trigger point work, where no glide is desirable. Here, there will be no or very little lubricant used.

On the other end, you have very superficial or circulatory massage, where there will be a lot of slip, and only the top layers of tissue affected.

In between those two extremes, we have the varying degrees of friction allowing deeper work into the tissue. While massage lubricants are designed to stay on the skin surface, each will have varying degrees of uptake (The Absorption Rate) into the skin. This will affect the amount of glide.

Viscosity: Viscosity refers to the thickness of the lubricant. Oil has the lowest viscosity, very liquid, and cream the highest. Within the categories of massage lubricants, there are also varying degrees of viscosity. For instance, there are thinner oils (fractionated coconut), or heavier blends of oils (Almond), as well as thicker or less dense creams.

1. Personal Preference
There is no right or wrong here. With experience, each practitioner will find their sweet spot or correct GVF . You will probably hear the statement that oil is used for Swedish massage and cream for deep tissue. That is an over generalization or simplification. The fact is, many experienced practitioners use oil and a variety of lubricants for advanced or deeper massage and conversely, creams can be used for Swedish massage. You will come to find which lubricant type you prefer and learn to use it correctly to achieve the desired outcome.

2. Modality or Technique Performed
The modality or technique performed will determine the amount of grip/friction and glide needed. Swedish massage, and modalities focusing on circulation, require a fair amount of glide. Trigger point, Myo Fascial, and Deep Tissue require less glide and more grip.

Is your massage treatment general and gliding, specific and deep, fast or slow?…… all of these questions will determine your GVF.

3. Desired Outcome
Another factor to consider for your GVF is desired outcome. Generally speaking, the massage lubricant is secondary to the reason people get a massage from you – your hands or manual skills. The lubricant just facilitates this and is not the focus. However, there may be other considerations to ponder: the “oiliness” factor left on a client after the session, care of linens, moisturizing or skin care effects, and therapeutic properties of the lubricant.

Oils
On the viscosity scale, oil is the least viscous, most liquid. Because of this, it has a high glide coefficient and is suitable for treatments or modalities requiring less friction. However, as stated above, there is some wiggle room here. Use very little oil, and friction increases. Because oil is liquid, it can be messy and easily spilled…. something to consider. Pump Bottles and Holsters can help keep your treatment space clean.

Further considerations: Because oils contain no water, they require little or no preservative. Vitamin E is sometimes added to act as a preservative, but its effectiveness in this capacity is up for debate. However, use caution. Oils can turn rancid very quickly. My nose can sense this very quickly. I have known practitioners to use oil well beyond its freshness date. The easiest way to determine freshness is to do the smell test. If it smells like vanish or polish, it’s bad. Most oils have little or no scent. Some, like olive and jojoba, have distinctive scents and you can readily distinguish between its inherent scent, and rancidity. Scented oils will make freshness harder to determine.

Types: Most manufacturers produce blends of oils for massage. Read the ingredient list on the bottle to determine what’s in your oil, or see our ingredient guides on the below links.

Let’s look at some specific oil properties:

Almond (and other nut oils) – Almond oil is a common ingredient in many oils. However, nut oils as of late, have become ingredient non grata. I think some if this is unfounded and nut oil allergies are overstated. It could very well be rancidity causing the issues.

Grapeseed Oil – I love the oil. It is super moisturizing and beneficial for the skin and has medium viscosity within the oil family. Please note, grapeseed oil can be very staining to clothes and linens!

My favorites – Coconut and Jojoba. This is my preferred blend for the following reasons: they are very stable, meaning have a long shelf life (well over 1 year without any preservatives). They are also very clean was wash easily out of linens, a big bonus.

Coconut Oil is solid at room temperature. Fractionated Coconut Oil is the liquid form of coconut oil. This is, in fact, a much more desirable form of coconut oil, because it is much more stable than regular coconut oil and retains a higher percentage of its anti oxidant properties. Technically, this is achieved by removing almost all the long chain triglycerides present in the oil (which is the least stable portion prone to oxidation), via the safe process of hydrolysis and steam distillation.

Jojoba Oil is actually a wax ester, not strictly an oil. However, it has the appearance and viscosity of an oil, so we refer to it commonly as such. Pure Natural Jojoba (pronounced ho-ho’ba), is a botanical extract derived from jojoba seeds producing the pure liquid esters. Because of its oxidative stability and complex structure of long chains of fatty acids, Jojoba is the ideal lubricant for massage and skin health.

Coconut and Jojoba, like my favorite beer and coffee, are also more expensive than standard oils.

Gels
Gels are a very popular lubricant choice for many practitioners. Gels are produced by starting with an oil and adding a wax base, producing a thicker oil with a higher viscosity. Proponents of gel claim it has glide of an oil, with the workability of a lotion. Treating dry skin or working through hairy skin may benefit from the use of gels.

Lotions
Lotions take us up the viscosity scale and also introduce the use of water into the equation. This has the following ramifications: Water and Oil do not mix – necessitating the need of emulsifiers, stabilizers and similar substances.

Preservatives – when you add water, unless you plan on using it quick or freezing it, you must add a preservative, or else you will produce a science experiment like in high school. Remember those? Lotion, while more viscous than oils and gels, are all easily pumpable, whether from the Gallon jug or 4 or 8 oz bottles. There are many lotions on the market. All will have similar viscosity, but the texture and feel will be slightly different across the board. A lotion’s overall characteristics will be determined by how the manufacture creates the water/oil emulsion, via the stabilizing agents and ingredients used. I urge you to have fun and test and experiment with lotions.

Creams
Creams represent the thickest or highest viscosity of all the lubricants. When considering a cream, keep in mind that the thickest choices are not pumpable. Non pumpable creams can be applied from a jar or a tube. Many tubes are refillable for convenience. The correct procedure here is to draw from a bulk jug (gallon or half gallon) via a clean spatula or spoon, into a jar or tube. If a jar is used, it must be cleaned and refreshed for each client. Please note, for creams that are pumpable, these pumps are heavier duty than those pumps for lotion. Do not attempt to use lotion or oils pumps for cream!

Again, like lotions, there are countless types of cream for you to try and experiment with. Each will have its own unique overall feel.

No discussion of massage creams would be complete without a discussion of Biotone Dual Purpose Cream, uh, Creme, that is, from Biotone. This is without a doubt, the standard, the original, the cream (creme) that all others are judged by. If imitation is the sincerest form of flattery, then Biotone is top dog of the creams. The shear number of copycats is mind boggling, and the tortured names to try and ride Dual Purposes coat tails is bewildering: Multi Purpose, All Purpose, and so on. I suggest On Purpose, or Tri Purpose! Anyone else have some good names?

Something has troubled me for a long time. What does “dual purpose” stand for? I think the answer is in this next clip. Watch LaVelle from Biotone:

NicejobLaVelle! You get the Lief Montgomery thumbs up for clear product presentation and Biotone mission statement. However, I did catch an error. Dual Purpose does not come in 1/2 Gallon size. It is actually a confounding 68oz – 1/2 Gallon + 4 oz. Like the mysterious “Dual Purpose” definition, LaVelle, please clear up thought behind the size choice. Is it a Feng Shui thing, or maybe a metric thing? You do prefer the French creme to the more common cream. Merci.

Labels
You will find a lot of labels, like Natural and Organic, thrown around on products these days. Customers make a lot of assumptions about what these mean. I have also found that it’s hard to get a straight answer from anyone on this subject.

The term Natural is so broad, general, vague, mis-used and abused, to make it practically irrelevant. I recommend disregarding the “Natural” label and carefully reading the labels and ingredient list to make sure it fits your needs and expectations.

Here are some of the additives I found in a popular “Natural” massage cream: (Cetearyl Alcohol, Polysorbate 60, Phenoxyethanol,Diazolidinyl Urea (and) Iodopropynyl Butylcarbamate, Carbomer)

How’s that for “natural”!

OrganicThe Organic label is very similar. Perhaps there will be several organic ingredients in the list, with the rest a mix of Latin and multi syllable chemical structures you might even hesitate before putting in your car’s radiator. Just kidding! I am exaggerating, a little. Just read the label please!

HypoallergenicThe hypoallergenic label usually refers to products free of any fragrance, scents, or nut oils. This does not guarantee that it will not cause allergies or irritation to someone. Always test first with sensitive types. Oddly enough, we find the toughest reaction and allergy issues are resolved by using a completely unnatural solution…. Petroleum based lubricants You would be surprised at how many common (and high end!) consumer moisturizers and lotions are either petroleum based or have some petroleum derivatives in the ingredient list.

VeganThe Vegan label is perhaps the most interesting of them all. Vegan? Sacred Earth is the only brand I know of spouting this label. Does this mean that Bon Vital and Biotone are not? I am familiar with Vegan in terms of food – the lack of animal products. I am pretty sure that none of the major brands we are discussing here include animal products.

On this same theme, many massage lubricant manufacturers advertise that they do not test their products on animals. I find this hard to believe. I get lots of samples of massage oils, lotions and cream in my travels. I take them home and always test it on my dog first. And she LOVES IT!!!! So listen up manufacturers, you have it backwards. Label it, Certified Massage tested on animals and they LOVED IT! You can thank Leif for that.

Ingredients
So now we come to the topic of ingredients. For some reason, people freak out about their massage lubricant over certain ingredients. For instance, parabens has been all but excluded as an additive. I understand the concern and agree that I want products as clean, fresh and high quality as possible. But please do not freak out on Lief until you checked the ingredient list from all the products, soaps, shampoos, moisturizers, make up, deodorants, in your own bathroom. If they are all “pure”, then go ahead and freak out. The fact is, across the board, the massage lubricants that I mention here from the major manufacturers are as high quality, or higher quality, that those products in general use by most people. So rest assured please. If you happen to be particularly discerning, demand strict purity, will not use any preservative, then you will have to do a little extra work, pay higher prices, and make some compromises. We will compile a complete ingredient list for you to reference of the major massage lubricants as well as a glossary of some of the more esoteric ingredients you’ll come across. (Look for this in about 1 week)

Additives – Specialty
As I mentioned earlier, the focus of the massage treatment is the massage/manual skills of the practitioner. The choice of the lubricant, with the correct GVF, merely facilitates this. Additives refer to the addition of herbs, extracts, and essences to achieve a biologic effect, as well as add a little scent. Examples include arnica, ivy, or ilex herbs, extracts of seaweed, algae, and essences of lavender, chamomile, ginger, etc. There are many different additives used in lubricants. Here is a partial list with functions. (coming soon)

The specialty lubricants I am referring to are the ones creating heat or cold sensations when applied. These will be used alone as a topical treatment, or in conjunction with massage/manual treatment. The active ingredient that creates the heat/cool effect is Menthol or Camphor or a combination of the two. The higher the concentration of Menthol, the stronger the effects. If you are doing spot treatments, higher concentration is OK. If you are including massage to the area, or even full body massage, lower concentration is advised. Please keep in mind, as I am sure you are aware, there is a smell associated with these products.

I have heard it mentioned that practitioners sometimes dilute these formulas by adding to unscented lotions or creams and using as a whole body lubricant. Not my cup of tea, but some might find it useful.

Cost Per Treatment
A useful and illuminating exercise is to determine your lubricant cost per treatment. I mention this because I lean toward using high quality products and ingredients.

Many practitioners feel they are constrained by price. So lets do the math. The rule of thumb is 1oz of cream used per treatment. For oils of lotions, it may be a little higher than 1oz. So for a base price of $50 per Gallon of Cream, you would perform 128 treatments. This works out to around 40 cents per treatment. So lets say on the high end we use a $90 cream. This equals 70 cents. A $25 cream (I do not know any, nor do I want to!…..knowing some major ingredient/water substitution would need to be made) equals 20 cents. Using that formula and tweaking for your preferences and use should give you some perspective on the money factor. Is 40-60 cents unreasonable per treatment? As an independent practitioner, using a cheaper lubricant and saving 15 cents per treatment saves about $5 a week based on 30 treatments. If you are a clinic or spa owner, with multiple rooms, that changes the equation and you will have to decide what is appropriate. Keep this in mind, you can always advertise that you use such and such expensive formula in your treatments, sending the message that you care and are focused on the details. Conversely, you would not want it be to known, you use cheap brand X! I once heard that mineral oil (baby oil) was being used in those massage store fronts popping up all over New York and the East Coast. Why not motor oil (recycled)!

If you do use a high end product, you may want to consider offering retail sizes for re sale, or give samples free if you prefer, for take home. The take home product would be an altered version of the massage lubricant, because honestly speaking, massage lubricants are not the best choice for home skin care and moisturizing (they are designed for massage). We can discuss this idea more in a later segment.

Measurements/Specs
I need to add this section because I find people often stumble over ounce/Gallon conversions. So we do not embarrass ourselves, let’s study the following!

Laundry Care and Precaution
The combination of linens, oil, and heat can create a combustible combination during drying and storage. Use care, lower temperature settings in the dryer and read your dryers manufacturer guidelines for care of linens that have been exposed to oil.

Best practices for care and cleaning of your linens. Clean your linens as soon as possible after use. The longer they sit with oil, the more difficult it will be to clean. Try not to overuse your massage lubricant, otherwise all the excess will end up on the sheets. As we stated above, certain oils are much cleaner and easier to launder out of sheets than others, lotions and even more so creams tend to collect less in linens. If you find difficulty in getting your sheets clean, consider a specialty detergent designed to work just on getting out oil. Eventually, you will have to replace your sheets. Just the cost of doing business. If they are stained and have a rancid smell, do not delay in replacing. Customers pick up on queues and make judgments based on this. You want to present your best image.